The Quality Assurance Process COG SWL | Nicholas Duffin
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The Quality Assurance Process 6 stages of evaluation for programmes of engagement and/or consultation Before 1. Scope/mandate and decision making engagement or 2. Project plan consultation 3. Information and documentation starts During 4. Mid-review (in the middle few days) engagement or 5. Closing review (in the last week) consultation After the 6. Final report (reviewing the information for engagement or decision making) consultation finishes
The Quality Assurance Process 5/4 stages of evaluation for option development and/or option appraisal Option 1. The balanced room development 2. Information - informing those involved 3. Process (Plan) 4. Information - contained within each solution 5. Report Option appraisal 1. The balanced room 2. Information - informing those involved 3. Process (Plan) 4. Report
The Quality Assurance Process What we are looking for: 1. Is it looking lawful 2. Does it look like good or best practice
Engagement Impacts analysis Developing case for change Planning Status quo mapping Investigation/research/analysis The model timeline Impacts relevancy testing Sense checking Risk evaluation Impact(s) assessment(s) Issues or discussion paper Early involvement (SHs/SUs/IPs) Early involvement (Imp profiles) Engagement Solutions based dialogue Impacts exploration Values discussion Impacts debate Criteria establishing Conclusions testing Intelligence gathering Threat profiling Risk testing Outputs evaluation & analysis Outputs evaluation & analysis Updated impact(s) assessment(s) Reports & updated case for change Options development Criteria confirmation Challenge Option appraisal point Option confirmation To consult or not? Intelligence gathering Impacts updating Risk evaluation Consultation planning Information mediums development Updated impact(s) assessment(s) Consultation documents Consultation Impacts debate Consultation Impact claims testing Options testing dialogue Outputs evaluation and analysis Outputs evaluation and analysis Updated impact(s) assessment(s) Consultation reports and feedback Debate Challenge Reflection point Decisions Updated impact(s) assessment(s) Publish decisions and rationale
Framework of the law Health Legislation Legislation Local Gov Legislation Public & Common Equality Legislation Law
Framework of the law Legislation Public & Common Gunning Principles Law Brown/Bracking Principles
Framework of the law - Health & Social Care Act 2012 S14Z2 Public involvement and consultation by clinical commissioning groups 2. The clinical commissioning group must make arrangements to secure that individuals to whom the services are being or may be provided are involved (whether by being consulted or provided with information or in other ways) — a) in the planning of the commissioning arrangements by the group, b) in the development and consideration of proposals by the group for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which the services are delivered to the individuals or the range of health services available to them, and c) in decisions of the group affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.
Framework of the law – NHS Act 2006 S242 (1B) Public involvement and consultation Each relevant English body must make arrangements , as respects health services for which it is responsible, which secure that users of those services , whether directly or through representatives, are involved (whether by being consulted or provided with information, or in other ways) in — a) the planning of the provision of those services, b) the development and consideration of proposals for changes in the way those services are provided, and c) decisions to be made by that body affecting the operation of those services.
Framework of the law - Heath and Social Care Act 2012 14T Duties as to reducing inequalities Each clinical commissioning group must, in the exercise of its functions, have regard to the need to — a) reduce inequalities between patients with respect to their ability to access health services, and b) reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services. Plus other impact assessments if appropriate
Framework of the law - Equality Act 2010 S149 Public sector equality duty 1. A public authority must , in the exercise of its functions, have due regard to the need to — a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act; b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it. 3. Having due regard to the need to advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it involves having due regard, in particular, to the need to — c) encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low
Framework of the law - Local Authority Regs 2013 - HOSC CCGs must: Notify of substantial developments or variations Consult the local authority S23(9) Subject to paragraph (10), the authority may report to the Secretary of State in writing where — a) the authority is not satisfied that consultation on any proposal referred to in paragraph (1) has been adequate in relation to content or time allowed ; b) in a case where paragraph (2) applies, the authority is not satisfied that the reasons (emergency changes) given by R are adequate ; or c) the authority considers that the proposal would not be in the interests of the health service in its area . S30 requirement to appoint joint scrutiny panels
R ex p Gunning v LB Brent 1985 - the Gunning Principles Gunning I : “a consultation must be at a time when proposals are still at a formative stage” Gunning II : “must give sufficient reasons for any proposal to permit of intelligent consideration ” Gunning III : “ adequate time must be given for consideration and response” Gunning IV : “the product of consultation must be conscientiously taken into account”
Equalty Act 2010 - PSED - Brown and Bracking Principles R (Bracking & others) v Secretary of State for Work and Pensions 2013 (Independent Living Fund) 1. Equality duties are an integral and important part of the mechanisms for ensuing the fulfilment of the aims of anti-discrimination legislation. 2. An important evidential element in the discharge of the duty is the recording of the steps taken by the decision maker in seeking to meet the statutory requirements. 3. The relevant duty is on the Minister or other decision maker personally . 4. A Minister (or decision maker) must assess the risk and extent of any adverse impact and the ways in which such a risk may be eliminated before the adoption of a proposed policy. It is not a rearguard action following a concluded decision.
Equality Act 2010 - PSED - Brown and Bracking Principles R (Bracking & others) v Secretary of State for Work and Pensions 2013 (Independent Living Fund) 5. The duty to have due regard to the relevant matters must be fulfilled before and at the time when a particular policy is being considered and it is a continuing one. The duty must be exercised in substance , with rigour and with an open mind . It is not a tick box exercise. 6. It is not for the court to determine whether appropriate weight has been given to the PSED. 7. The concept of due regard requires the court to ensure there has been a proper and conscientious focus on the statutory criteria . 8. Public authorities must be properly informed before taking a decision. If the relevant material is not available, there will be a duty to acquire it and this will frequently mean more consultation with appropriate groups is required.
How are they involving service users and others Status quo Solution Solution Option Consultation analysis exploration development appraisal • Baseline audit of existing service(s), including: • How they meet the Equality and Health Inequality Duty - the gaps that need improvement (and why) – engaging relevant profiles of people for views and evidence. • Analyse of service user data held - for future engagement • Stakeholder mapping - building a profile for engagement • Engaging with staff, service users and interested parties to establish what works, what doesn't, thoughts on what needs improvement (and why). • Research on alternative models and successful transformation elsewhere • Sense checking conclusions with relevant parties • Risk evaluation - early identification of risks that might cause challenge
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